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USAID Funds Partnership to Identify and Forecast Zika 'Cold Spots'

Oct 17, 2016

The Arnhold Institute for Global Health at the Icahn School of Medicine at Mount Sinai, software company Dimagi, and Guatemalan NGO TulaSalud announced today that their partnership to locate and assess vulnerable areas in Guatemala to determine their level of risk for a Zika epidemic is being funded by the U.S. Agency for International Development (USAID). The funding is part of the Combating Zika and Future Threats Grand Challenge, a $30 million challenge that called upon the global innovator community to generate cutting-edge approaches to fight the current Zika outbreak and to help strengthen the world’s ability to prevent, detect, and respond to future infectious disease outbreaks.

Using predictive algorithms, the partners will develop a platform that pairs Dimagi’s technology, CommCare, with DigitalGlobe satellite imagery over the Arnhold Institute’s Health Equity Atlas platform (ATLAS). The goal is to identify areas where data such as health indicators, demographics and other household-level information, commonly referred to as “cold spots,” are absent, and protect the most vulnerable communities from becoming disease hot spots. This technology will be first implemented with the Guatemalan NGO TulaSalud (supported by the Tula Foundation), who has built a sophisticated frontline health worker digital service on the CommCare Platform. While the funding was provided specifically for technology used to forecast regions vulnerable to Zika in Guatemala, the hope is that the work will inform similar projects on a global scale.

ATLAS is designed to analyze underreported communities so that health care systems and policy makers can assess the needs of these vulnerable regions and better manage disease outbreaks where and when they occur, or the steady rise in chronic diseases over time and place. ATLAS is a spatial data engine that highlights blind spots in demographic and health information by analyzing inputs from frontline health workers and high-resolution, satellite imagery. The platform is being developed with the Office of the UN Secretary-General’s Special Envoy for Health in Agenda 2030 and for Malaria, and satellite imagery company DigitalGlobe, Inc.

“Information gaps exacerbate vulnerabilities to health crises, and we know that when epidemics strike, and health inequities are present, resources are naturally diverted to areas where there is known information about confirmed cases or well-defined infrastructure for intervention,” said Prabhjot Singh, MD, PhD, director of the Arnhold Institute for Global Health and chair of the Department of Health System Design and Global Health, Icahn School of Medicine at Mount Sinai.

“The ability to respond to epidemics depends upon having accurate, reliable information that is tied to service delivery capabilities. We have developed a tool that will enable ministries and other key decision makers to find these cold spots and intervene—preventing outbreaks of disease from becoming epidemics and thus averting massive financial costs, as well as significant morbidity and mortality,” said Dr. Singh.

A major outbreak of the Zika virus began in Brazil last year and has spread to approximately 60 countries around the world. Zika is transmitted to people through the bite of infected female mosquitoes, primarily the Aedes aegypti mosquito. According to the Pan American Health Organization (PAHO), Aedes aegypti mosquitoes are found in all countries in the Americas except Canada and continental Chile, and the virus will likely reach all countries and territories of the region where the mosquitoes are found. There is no current treatment for Zika, and a vaccine is not expected to be ready for widespread use for up to three years.
“TulaSalud is thrilled to work with Dimagi and the Arnhold Institute for Global Health on this project,” TulaSalud CTO Ray Brunsting said. “As an organization, we are leveraging and scaling CommCare as a frontline mobile service delivery tool, while also creating our own tools and systems to map incoming data. By combining this functionality together, there’s potential to further strengthen not only our digital health services systems, but so many other organizations’ as well.”
The ATLAS platform has three major components: (i) a spatial visualization tool that enables decision makers to view household level information for health-related data; (ii) a suite of machine learning algorithms that continuously extract health-related information and automated population estimates from satellite imagery; and (iii) a disease-specific risk engine that aggregates multiple datasets (such as the density of pregnant women, bodies of standing water, air temperature, and humidity) and produces a disease-specific risk score. James Faghmous, PhD, Chief Technology Officer for The Arnhold Institute, manages the ATLAS platform.

A critical component of the ATLAS approach to identifying potential Zika hot spots is its integration with digital applications that are regularly used by frontline community health workers. CommCare is one of the most widely adopted digital platforms for frontline workers in low-resource settings.

“By pairing CommCare data with DigitalGlobe imagery over the ATLAS platform, cold spots can be quickly identified and checked by appropriate parties to determine the exposure to Zika and deliver an efficient response,” said Jonathan Jackson, co-founder and CEO of Dimagi. “This approach is game-changing because it leverages existing data in a novel way; if you are already using CommCare, you don’t have to change anything. We have the team and technology to realize the impact and curb future threats.”

Dimagi maintains a regional office in Antigua, Guatemala, where field work will be coordinated. Engineering work will be divided between The Arnhold Institute in New York City and Dimagi headquarters in Cambridge, Mass.